Sierra Leone Cross Border Strategy on Prevention and Control of Ebola Operationalization of the Monrovia Communique.

Sierra LeoneCross Border Strategy on Prevention

and Control of Ebola

Operationalization of the Monrovia Communique

Situation from Border Districts

Background to Monrovia Communique

Technical meeting on Cross Border collaboration on the prevention and control of Ebola (09 Dec 2014 in Monrovia)

DELEGATES:• Governments of Sierra Leone, Liberia, Mali• UNMEER, MRU, AU• UN Response teams from Guinea, Mali, Sierra Leone, Liberia

Context:• Cross-border transmission as a prominent feature of the EVD outbreak;• More than a thousand informal and poorly regulated border crossing

points across MRU;• Border communities share livelihoods and population movement

patterns do not regard formal borders

(Select) Recommendations from the Monrovia Communique to inform Sierra Leone strategy

• Laboratory samples should be transported to the nearest testing lab, regardless of borders, and results shared in real time.

• “Open Border Policy” that allows patients to be treated at the nearest Ebola treatment facility without stigmatization because of nationality.

• Authorities on either side of the border share contact lists and information for monitoring and action on a daily basis; and UNMEER support the establishment of a cross border contacts database to facilitate information flow.

• Entry and exit points have reinforced capacities for screening, isolation. Rapid response teams with ambulance capacity should be positioned at formal border crossings and be supported with mechanisms to facilitate deployment across borders, if necessary.

• Ebola supplies be prepositioned near border posts with high cross border traffic allowing for cross border deployment.

• Full involvement and leadership by elders and traditional leaders, and the building of a network of local, national and international anthropologists amongst them for effective EVD control.

Sierra Leone Strategy Border Surveillance and Response

Mano River Union: shared information, guidelines and resources across borders, in line with the recommendations of the Monrovia Communique

District Specific Operations: strong community watch networks; engagement with community and traditional leaders, community-based surveillance contact tracing and social mobilisation

Medical Response: Hubs to be established with necessary surveillance, labs, case management resources (labs, CCCs / EHCs/ ETCs, vehicles, etc.) – to be accessible regardless of nationality

Security: support of SLP, RSLAF, ONS, Customs, Immigration, to work with communities and authorities to monitor and enforce border security.

Border

BorderCrossingPoint

Sierra Leone

Pujehun District

Liberia

Grand Cape Mount

Enablers:

MRU: framework for cooperation and shared resources across borders, regardless of nationality

Security: facilitate implementation of the framework: providing support to border area, liaising with community watch groups, and coordinating logistics

BorderCrossingPoint

ETC& Lab

CCCCCC

CCC

Medical Response Facility (isolation or treatment) &/or Lab

Sierra Leone

Pujehun District

Liberia

Grand Cape Mount

Implementers:

Community Response: strong community watch networks; community-based surveillance and contact tracing

Medical Response: hubs to be established with necessary surveillance, labs, case management resources (labs, CCCs / EHCs/ ETCs, vehicles, etc.) – to be accessible regardless of nationality

BorderCrossingPoint

ETC& Lab

CCCCCC

CCC

Community surveillance and watch networks

Medical Response Facility (isolation or treatment) &/or Lab

Sierra Leone

Pujehun District

Liberia

Grand Cape Mount

ETC& Lab

CCCCCC

CCC

Community surveillance and watch networks

Medical Response Facility (isolation or treatment) &/or Lab

Joint Forces Command Centre, Logistics Base (located at a formal check point)

Sierra Leone

Pujehun District

Liberia

Grand Cape Mount

ETC& Lab

CCCCCC

CCC

Community surveillance and watch networks

Medical Response Facility (isolation or treatment) &/or Lab

Joint Forces Command Centre, Logistics Base (located at a formal check point)

Contact tracingSurveillance

Reports

Monitoring, Reporting,Logistics requests /

coordination

Sierra Leone

Pujehun District

Liberia

Grand Cape Mount

Contact tracingSurveillance

Reports

Monitoring, Reporting,Logistics requests /

coordination

ETC& Lab

CCCCCC

CCC

Community surveillance and watch networks

Medical Response Facility (isolation or treatment) &/or Lab

Joint Forces Command Centre, Logistics Base (located at a formal check point)

Patient transfer

Lab transfer

Sierra Leone

Pujehun District

Liberia

Grand Cape Mount

Moving towards an operational plan

• Internal discussion and agreement on concept of cross-border collaboration;

• Political discussions and agreement within the MRU, whilst working on the plans to operationalize the principles and concepts of cross-border collaboration;

• Begin conversations with Liberian counterparts on the next steps and way forward (whilst MRU is discussing with Guinea);

• Prepare for launch of plan once MRU formalizes the agreement.

Community-based surveillance and watch groups in

border communities

Medical ‘Hubs’ with border-free

access

Logistical support and surveillance at border points

Strategic Area Key Stakeholders Key questions / areas to consider for planning

•Surveillance Pillar•DERCs•Traditional leaders•Youth groups & women’s

groups (especially traders)•SLP•UNMEER

•How to strengthen local, community networks, including across borders?•How to best train and resource border communities in

this area?•How to best engage traditional/community leaders,

youth groups and women groups in a sustainable manner?•How do these groups interface with security forces on

either side of the border?

•Case Management Pillar•Surveillance Pillar• Labs•RSLAF / Immigration / SLP•UNMEER / WHO / CDC / UK

JIATF

•Strategic locations for Hubs in Sierra Leone & key areas for access across borders;•Security needs for facilitating access across borders;•Communication needs;•Current availability and gaps in S.L. hub facilities (labs,

CCCs, ETUs, ETCs)

• Logistics Pillar•UNMEER / UK JIATF / US Emb•RSLAF / Customs• Immigration / SLP

• Identifying locations for potential joint forces command centres (consider medical hubs)• Logistical support and management at border locations•Strengthening surveillance and health checks at formal

crossing points

MRU Collaboration

•GoSL•NERC, MoHS, MoD, SLP, etc.•MRU, ECOWAS, AU•UNMEER

•Political engagement for signature of MOU•Planning and logistical arrangements:

•National and Community Ebola Response•Security•Medical Response

Operational Plan Development (Proposed Working Groups)